This project will implement regional health information exchange within an established collaborative of rural hospitals, clinics, public health providers, behavioral health providers, and others across a 14,000 square mile remote area. The project will demonstrate phased health information exchange mechanisms among partners who have committed over $1 million annually. The exchange will accommodate partners with substantial, standards-compliant existing assets and will equip partners with little or no assets to develop capacities (with an emphasis on economies that are achievable through collaborative purchasing, training, and support). Upon completion of the three-year project: 1) Electronic medical records will be established and integrated with other functional systems (decision support systems, CPOE/e-Prescribing, results management, laboratory) in all Critical Access Hospitals and Rural Health Clinics through a common process and shared resources in order to enhance local and regional capacity development toward health information exchange; 2) Health information exchange systems will be established that will provide current information, from all hospitals and rural health clinics, at the point of care; and 3) An operational entity and incorporated RHIO will provide the sustainable infrastructure necessary to support regional health information exchange and common developments in the Electronic Health Records. [unreadable] [unreadable] The plan will model a solution applicable to small hospitals across the nation, because the plan will accommodate the wide variability in technological capacity and readiness represented by the partnering organizations. Project partners include all the area's hospitals, the public health entity, a membership organization of nearly all health and human services providers, and the University of Nebraska. [unreadable] [unreadable]